POS0203-HPR THE RELATIONSHIP BETWEEN PATIENT-REPORTED QUALITY OF LIFE AND PHYSICIAN-DERIVED CLINICAL OUTCOMES IN RHEUMATOID ARTHRITIS: AN ANALYSIS FROM THE AUSTRALIAN OPAL DATASET
Authors: G. Littlejohn, N. Anbumurali, C. Osullivan, T. Smith, T. Racunica, P. Pentony, S. Jayaweera, L. Girgis, C. Deakin
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Remission or low disease activity (LDA) are the common therapeutic targets in the treat-to-target strategy for patients with rheumatoid arthritis (RA). Despite achieving these targets however, some patients continue to experience residual symptoms including pain, fatigue and functional loss. Patient reported outcomes (PROs) are an important tool to better understand the lived experience of the patient which is often not adequately captured by traditional disease activity measurements. <h3>Objectives</h3> To describe the levels of pain, fatigue, mood disturbance and physical function in a large cohort of Australian patients with RA and how they correlate with traditional clinical disease activity measures. <h3>Methods</h3> Clinical data were sourced from the OPAL dataset which is an aggregated collection of data extracted from the electronic medical record (EMR, Audit4, Software4Specialists Pty Ltd) of patients receiving routine care from 112 rheumatologists across Australia. Validated PRO questionnaires were electronically delivered to patients through their EMR via email or completed using a smart device in the waiting room prior to the consultation. Completed questionnaires were securely integrated into the patients EMR for review at the next consultation<sup>[1]</sup>. Patients with a physician diagnosis of RA and ≥6 months of disease activity recorded who had responded to at least one PRO (Functional Assessment of Chronic Illness Therapy Fatigue (FACIT-F), Patient Health Questionnaire-2 (PHQ-2), pain visual analogue scale (VAS) or the Multi-Dimensional Health Assessment Questionnaire (MD-HAQ)), between April 2020 and April 2022 were included. Disease activity was assessed using DAS28(3)-CRP which includes swollen and tender joint counts and CRP, but excludes the patient global assessment. <h3>Results</h3> 1,397 patients completed a pain VAS, 2,180 a FACIT-F, 2,101 a PHQ-2 and 2,243 a MD-HAQ during the study window. The median age of patients with a completed questionnaire was 62 years and 77.1% were female. Levels of pain, fatigue, mood disturbance and physical function for patients with RA are shown in Table 1. Overall, a substantial percentage of patients, (n=519, 37.2%), reported experiencing unacceptable pain (&gt;40mm VAS) and clinically relevant fatigue (FACIT-F ≤ 34) (n=867, 39.8%). Higher levels of pain, fatigue and mood disturbance was associated with higher DAS28(3)-CRP disease activity. Of patients in DAS28(3)-CRP remission or LDA, 32.7% reported unacceptable levels of pain, 36.1% reported clinically relevant fatigue and 11.2% reported possible depression. <h3>Conclusion</h3> In general, we found that higher disease activity scores were associated with high levels of pain, fatigue, anhedonia and depressed moods. In addition, there exists a substantial cohort of patients in routine clinical care with swollen and tender joints counts and CRP levels indicative of remission or LDA that continued to experience unacceptable levels of pain and clinically relevant fatigue. <h3>Reference</h3> [1]Tymms K, Smith T, Deakin C, et al. The Development Of A Novel ePRO Delivery System To Measure Patient Quality Of Life In Routine Clinical Care: An Analysis Of 5 Years Of Experience [Abstract] Annals of the Rheumatic Diseases. 2021; 80(S1):1015-1016 <h3>Acknowledgements</h3> The authors acknowledge the members of OPAL Rheumatology Ltd and their patients for providing clinical data for this study, and Software4Specialists Pty Ltd for providing the Audit4 platform. This study was conducted with the support of an investigator-initiated study grant provided by AbbVie Australia. <h3>Disclosure of Interests</h3> None Declared.